Abstract: Current practices for the reversal of warfarin prior to cardiac surgery include the use of vitamin K and fresh frozen plasma (FFP) to reduce the risk of bleeding. While the 2010 International Society of Heart and Lung Transplantation (ISHLT) Guidelines acknowledge the use of PCC (Prothrombin Complex Concentrate), there is no clear consensus on its efficacy. The primary endpoint was to assess the efficacy of 4-factor PCC administration in patients requiring warfarin reversal prior to heart transplantation by determining blood product utilization perioperatively. Thirteen Patients who received PCC for warfarin reversal prior to heart transplantation were matched to a similar cohort of 39 patients from January 2011 to July 2015. Blood product utilization was collected retrospectively for the 24-hour preoperative, intraoperative, and 48-hour postoperative periods. Patients receiving PCC required fewer blood products in all three categories: 24 hours preoperatively, intraoperatively, and 48 hours postoperatively. Differences in blood product administration within the 24 hours prior to surgery were significant (p=0.002) with 22 patients (56%) and 1 patient (8%) in the control and PCC groups, respectively. No patients in the PCC group required FFP preoperatively. Intraoperatively, all patients received blood products. Of those who did receive them, the PCC group required fewer units of packed RBCs (median 3 units vs. 7 units p=0.034). In the 48 hours postop period, 20 patients (51%) in the control group and 2 patients (15%) in PCC group (p=0.023) received blood products. Prothrombin Complex Concentrate reduces blood products utilization 24 hours preoperatively, intraoperatively, and 48 hours postoperatively after cardiac transplantation. Historically the majority of patients have required FFP for warfarin reversal, yet in this single-center experience this need has been eliminated with the introduction of PCC.